title: Shockwave treatment for medial tibial stress syndrome in athletes; a prospective controlled study.
abstract: Objective The purpose of this study was to describe the results of two treatment regimens for medial tibial stress syndrome (MTSS); a graded running programme and the same running programme with additional shockwave therapy (extracorporeal shockwave therapy; ESWT).  Design A prospective observational controlled trial.  Setting Two different sports medicine departments.  Participants 42 athletes with MTSS were included.  Intervention Patients from one hospital were treated with a graded running programme, while patients from the other hospital were treated with the same graded running programme and focused ESWT (five sessions in 9 weeks).  Main Outcome Measures Time to full recovery (the endpoint was being able to run 18 min consecutively without pain at a fixed intensity).  Results The time to full recovery was significantly faster in the ESWT group compared with the patients who only performed a graded running programme, respectively 59.7±25.8 and 91.6±43.0 days (p=0.008).  Conclusions This prospective observational study showed that MTSS patients may benefit from ESWT in addition to a graded running programme. ESWT as an additional treatment warrants further investigation in a prospective controlled trial with the addition of randomisation and double blinding.
authors.affiliation: Rehabilitation and Sports Medicine Department, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, The Netherlands. m.moen@umcutrecht.nl
authors.forename: M H
authors.initials: MH
authors.lastname: Moen
authors.forename: S
authors.initials: S
authors.lastname: Rayer
authors.forename: M
authors.initials: M
authors.lastname: Schipper
authors.forename: S
authors.initials: S
authors.lastname: Schmikli
authors.forename: A
authors.initials: A
authors.lastname: Weir
authors.forename: J L
authors.initials: JL
authors.lastname: Tol
authors.forename: F J G
authors.initials: FJ
authors.lastname: Backx
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D056352:Athletes; D005080:Exercise Test / Q000379:methods; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D019220:High-Energy Shock Waves; D006801:Humans; D008297:Male; D058923:Medial Tibial Stress Syndrome / Q000628:therapy*; D011446:Prospective Studies; D020127:Recovery of Function; D012420:Running / Q000502:physiology; D055815:Young Adult